Date of Award
Open Access Thesis
MS in Physician Assistant Studies (PA)
Physician Assistant Studies
Eric Van Hecke, MPAS, PA-C, CAQ-EM, DMSC candidate
Background: Barrett’s esophagus is the most significant predictor of the development of esophageal adenocarcinoma. The current treatment recommendation is a proton pump inhibitor to control acid reflux, yet there remains a significant number of individuals who progress to cancer. More can be done to prevent this progression.
Purpose: To this end, this paper seeks to answer the following PICO question: P: Patients with Barrett’s esophagus not yet esophageal adenocarcinoma; I: Standard PPI treatment with the addition of Aspirin; C: Standard PPI treatment only; O: Prevention of progression of Barrett’s esophagus to esophageal adenocarcinoma.
Methods: A comprehensive literature review was conducted using PubMed, Sage Journals, and Science Direct using the search terms Barrett’s esophagus treatment, Barrett’s esophagus aspirin, esophageal cancer prevention aspirin, cancer prevention aspirin, and prostaglandin cancer. Inclusion criteria were peer-reviewed, scholarly journals and studies published during or after 2017. Excluded from the search were meta-analyses and reviews.
Conclusions: Aspirin shows promise as a possible adjunctive treatment to proton pump inhibitors. A long-term study is needed to specifically assess if adding aspirin will reduce progression to adenocarcinoma while also assessing safety. Several biomarkers and tissue pathologies are already available to risk stratify who could benefit from this add-on treatment.
Speakman, John, "A Role for COX Inhibition in the Prevention of Progression of Barrett’s Esophagus To Esophageal Adenocarcinoma" (2022). Theses and Graduate Projects. 1254.